Social Support for Older People 2023 - 2028 | East Dunbartonshire Council

Purpose of the policy

Formal building based day care services provided to older people in East Dunbartonshire are supported by the provision of three day centres, two in Kirkintilloch and one in Milngavie. One of the Centres supports older people from the BAME community. The support provided by these Centres are of a high quality evidenced by their Care Inspectorate inspections which graded both Oakburn and Birdston Day Centres with the highest grade applied ‘6’ and Milan received grades of ‘5’. These inspections evidence that the service users, their families and the staff working in the Centres place significant value on the services with some carers also benefiting from respite while service users are in attendance.

The Social Care (Self Directed Support) (Scotland) Act 2013 implemented in 2014 enabled individuals and their carers to have as much choice and control as they would wish or are capable of in relation to their support. This has seen some small changes over the last six years in the way that some older people have chosen, in relation to the model, to meet their social support needs.

However, needs analysis has evidenced that those service users, who meet the eligibility criteria for social support, largely choose a formal building based day centre support to meet those needs and outcomes. Many referrals for formal social support are received into the Health and Social Care Partnership (HSCP) at the point of crisis for the individual.

The Strategy delivers ways that informal social support can be provided to older people at an earlier stage in their timeline continuum so that they can continue to enjoy community and peer inclusion for an extended period before there is no other option to move to formal centre based support.

Pre the Covid-19 pandemic, East Dunbartonshire enjoyed an abundance of informal community clubs and activities targeted at supporting older people to remain connected to their local communities. All of these activities were suspended in March 2020. A number of the local community assets recommenced during September and October 2021 however there were a number of local clubs and groups who did not reconvene and have closed permanently. A result of the pandemic has been that many older people have deteriorated both physically and mentally due to social isolation from family, friends and peers. This is evidenced in the number and type of referrals that social work services has received throughout the pandemic.

East Dunbartonshire HSCP, in their five year Strategy, recognises that we need to change the way that people think about social support for older people, that being that it can only be delivered through formal building based day care settings. We recognise the important of encouraging older people to remain active in their communities as well as maintaining contact with their peers.

The HSCP undertook a Strategic Review exploring what older people, their carers and other stakeholders felt were important factors in accessing formal and informal social support opportunities in their local communities. The Strategy aims to ensure that older people have access to good quality information and advice about local resources and services. The Strategy focuses on the redesign of both formal and informal social support in East Dunbartonshire to ensure that there is a provision of social opportunities throughout a person’s later stages of their life including focusing on available resources in local communities, places that are familiar for older people as well as developing additional community social opportunities. The Strategy focuses on the actions required to be undertaken by the HSCP to build capacity within local communities alongside our third sector partners and keeping older people connected into the community where they live.

The needs analysis considered current service provision, the needs and disabilities of people receiving formal social support, the indirect benefit of current supports on unpaid carers, demographics and highlighting the wide spectrum of community activities for older people that were available pre-pandemic. The availability of these community groups and clubs post-pandemic has decreased with a number of assets closing permanently. However, of those community clubs that did recommence work is currently being undertaken to liaise with group leaders to ascertain any support that clubs may require to recommence such as increased membership, volunteer provision and grants/funding applications.

With this in mind, this Equality Impact Assessment was undertaken to formally capture contextual information relevant to different groups or individuals with protected characteristics and will be used to inform subsequent service proposals and implementation programme.

Specific service proposals Equality Impact Assessments will be undertaken to ensure any service change is compliant with the IJBs legal duties in respect of their Public Sector Duty.

Lead Reviewer: Kelly Gainty, Adults and Community Care Support Worker
Please list all participants in carrying out this EQIA: Derrick Pearce, Head of Community Health and Care Services Gillian Healey, Team Manager, Planning and Commissioning Margaret Friel, Planning and Commissioning Officer, Stephen McDonald, Manager of Adult and Older People Services Richard Murphy, Manager of Resources.

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Impact Assessment
What is known about the issues for people with protected characteristics in relation to the services or activities affected by the policy?
Do you expect the policy to have any positive impact on people with protected characteristics?
Do you expect the policy to have any negative impact on people with protected characteristics?
Actions to be taken

Impact Assessment

Does the policy explicitly promote equality of opportunity and anti-discrimination and refer to legislative and policy drivers in relation to Equality? Please provide excerpts from the document to evidence.

In the introduction to the Social Support for Older People Strategy, it states “The benefits of social support and interaction has never been more evidenced than it was during the pandemic. While many people turned to technology to maintain contact with the outside world, for many others, technology did not provide that much needed interaction for a variety of reasons…. We want to be ambitious, we want to build up the previous abundance of social opportunities that our older residents had access to as well as grow those opportunities. This Strategy comes at a time when East Dunbartonshire is witnessing challenging demographics, experiencing an increasing, above average, number of older people living in our local communities. It is important that we provide social support opportunities at earlier stages in older people’s lives to take advantage of the benefits that it provides”.

The Feeley Report (March 2021) highlights that the majority of social care support is given to people in their own houses or in local community settings and that we need to ensure that this community support continues. It suggests that the role that communities play in supporting adults to remain active is extremely important. Community based supports can provide socialisation opportunities, advice, information and breaks for unpaid carers. These community based activities can make a big difference to an older person’s quality of life. “Social connections are important to everyone’s wellbeing” (Feeley, March 2021).

East Dunbartonshire Social Support for Older People Strategy 2023 – 2028 has at its core the local implementation of supporting older people to remain as active citizens within their communities from a starting position where the individual is fully independent in their care needs, through the time line continuum to the final stages where the individual needs full social support stimulation via a formal funded service due to physical and/or mental disability.

Equality Act 2010

The Equality Act 2010 brings together over 116 separate pieces of legislation into one single Act. Combined, they make up the 2010 Act that provides a legal framework to protect the rights of individuals and advance equality of opportunity for The Act simplifies, strengthens and harmonises the current legislation to provide Britain with a discrimination law which protects individuals from unfair treatment and promotes a fair and more equal society.

Fair and equitable services

We will plan and deliver services which account for the different needs of older people who share a characteristic protected by the Equality Act. (p15)

Planning for place

We will target resources where they are most needed to reduce disadvantage caused by socio-economic inequality. This is known as using a “Place” approach.

What is known about the issues for people with protected characteristics in relation to the services or activities affected by the policy? For instance, a new flexible working policy might reflect on the additional burden experienced by carers or parents.

All
The Strategy will provide opportunities for older people to identify and utilise a variety of social support resources, of both an informal and formal nature depending on the individual’s physical and mental health needs. The eligibility criteria for attending a formal social support service will apply to older people with their eligibility determined by their assessed need.

The provision of social support can also indirectly benefit an unpaid carer and support them to continue in their caring role. Any identified unpaid carer will be offered the opportunity to complete an Adult Carer Support Plan via the HSCP or Carers Link. Any eligible needs identified will be supported utilising informal and formal assets.

The National Development Team for Inclusion (NDTi) have a body of research and evidence that shows that support led by community organisations has a significant impact on the quality of life for those who use those supports and it can drive improvements across the wider services.

A Fairer Scotland for Older People Framework, published in 2019, recognises the important of keeping communities connected and recognises that everyday activities is one of the means by which health and wellbeing can be supported.

The Scottish Government’s A Connected Scotland Strategy recognises the important of tackling social isolation and loneliness and building stronger social connections. It recognises the value in utilising community venues to keep people connected.

Sex
In East Dunbartonshire approximately 41% of older people utilising formal social support are male.

Older women are more likely to report feeling lonely than older men do, but this doesn't mean men aren't experiencing loneliness. Women may feel more able to admit they're lonely. Women are more likely to live longer than men and experience life events, like losing their partner, which can cause loneliness. Women are more likely to have wider social networks than men across their lifetime. Older men in heterosexual relationships are more likely to rely on their female partner for maintaining social networks. A greater percentage of older men (50+) report moderate to high levels of social isolation. Older men without partners report higher levels of loneliness and isolation than women without partners. Older men who live alone say they struggle to access social support for reasons such as older people's clubs and activities being dominated by women, a lack of activities that interest them, and a lack of male staff running services. Crucially older men also felt that they should be independent and self-reliant which stops them seeking helping more generally. (Age UK)

The Strategy seeks to develop informal and formal social support that specifically targets identifying older men who are experiencing social isolation and recognise the important of community assets targeted at meeting men’s social support needs for example, Milngavie and Bearsden Men’s Shed, Kirkintilloch Men’s Shed.

Gender Reassignment
No local or national data was available about older people under this protected characteristic grouping. This is an area that requires to be developed both nationally and locally regarding the recording of older people who have this characteristic.

Age UK provides information fact sheets about later life for transgender (or trans) people. The main focus is on growing older for people who have transitioned and live permanently in their affirmed gender. It also provides information for people in later life who are thinking about gender reassignment. The information covers a range of legal, financial and social care issues. It includes a guide to terminology and details of where to go for further information and support.

The NHS GG&C offer guidance on health needs of transgender people and how to address discrimination against trans people in their Briefing Paper on Gender Reassignment and Transgender People, as well as offering training for NHS staff on the subject of transgender people. The Strategy is fully inclusive to all. Partnership working, inclusive of the Third Sector, is highlighted in various themes within the Strategy and should also impact positively upon transgender older people as major research and policy direction around trans people are as yet largely shaped by the Third Sector organisations.

Race
East Dunbartonshire collects ethnicity statistical data for all customers and carers who have contact with the HSCP. The Pakistani community who make up 0/9% of Scotland’s population is the largest BME group. This is followed by the Chinese community with 0.6% and then by the Indian community with 0.5%. The Gypsy/Traveller population account for 0.1% of the total population. There is increasing evidence that Gypsy/Travellers experience significant health inequalities, and higher than average rates of major long-term conditions such as diabetes and cardiovascular disease.

In the report by Trotter R. (2012); ‘Over-looked Communities, Over-due Change’ published by the Equalities National Council and Scope found many Black and Minority Ethnic (BME) people with disabilities reported that access to services can be compromised by poor translation, inconsistent quality of care and weak links between services and communities. People with disabilities are more likely to live in poverty but BME people with disabilities are disproportionately affected with nearly half living in household poverty. And like all people with disabilities, many of those from black and minority ethnic backgrounds find themselves socially excluded and pushed to the fringes of society.

East Dunbartonshire currently has a dedicated older people’s day centre for the BME community. The Milan Day Centre was established at a time when a significant number of older people, were identified in the local communities as being non-linguistic in English and in need of formal day centre support meeting cultural needs. However, the Strategy recognises that the numbers of older people from the BME community with formal day centre needs has diminished and that the HSCP needs to focus the Strategy on meeting all cultural needs in their formal day centre settings, while providing opportunities to establish cultural peer support opportunities for those older people who have not yet reached the final stages of the time line continuum.

East Dunbartonshire HSCP recognises that any models of social support will need to support all individuals to achieve cultural integration and social contact by facilitating natural community connections. Formal social support will only be accessed by individuals whose assessed need meets eligibility criteria.

Disability
Older people with disabilities will benefit positively from the introduction of this policy. It will help to identify the various stages of increasing physical and/or mental health illness affecting older people, and where social support opportunities of a community led nature, will benefit the older person to remain connected with their peer group.

The HSCP’s strategic needs analysis identified that 68% of older people utilising formally funded social support had a main disability identified as dementia or Alzheimer’s, whilst the remaining 32% suffering from a physical disability or frailty.

Sexual Orientation
Many LGBT people fear potentially experiencing homophobia, biphobia and transphobia from services or have previous experience of discrimination from a service. There is often a lack of visibility of LGBT identities within services (such as staff knowledge of the issues affecting LGBT people, promotion of inclusive posters or websites and explicitly stating that the service is LGBT-inclusive) which are necessary to counter LGBT people’s experiences of discrimination or a lack of confidence that social services are able to meet their needs.

The LGBT group identify as much younger than those who are heterosexual, 4% of the LGBT group identify as 75 years plus compared to a tenth of heterosexual adults. The LGBT group are also less likely to report good general health. Adults from a mixed/multi ethnicity household were most likely to identify as LGBT. Older men in heterosexual relationships are more likely to rely on their female partner for maintaining social networks.

Religion and Belief
Older People in receipt of formal funded support generally do so after assessment of risk using approved Eligibility Criteria. The threshold for service receipt is current limited to people who are assessed as presenting substantial or critical risk.

East Dunbartonshire collects religion statistical data for all customers and carers who have contact with the HSCP. Religion, culture and beliefs also form part of the HSCP’s assessment process to support the identification and creation of a personalised support package.

East Dunbartonshire currently has a dedicated older people’s day centre for the BME community. The Milan Day Centre was established at a time when a significant number of older people, were identified in the local communities as being non-linguistic in English and in need of formal day centre support meeting religious and cultural needs. However, the Strategy recognises that the numbers of older people from the BME community with formal day centre needs has diminished and that the HSCP needs to focus the Strategy on meeting all religious and cultural needs in their formal day centre settings, while providing opportunities to establish cultural peer support opportunities for those older people who have not yet reached the final stages of the time line continuum.

Age

Demographic statistical data for East Dunbartonshire show that during 2015 – 2019, the number of customers receiving home care aged 65+ increased by 26%. Looking ahead to the next ten years, with continued increases in older people and most particularly the 85+ population expected to rise at a rate higher than any other Scottish local authority area, it is projected that East Dunbartonshire will experience a continued 5% year-on-year increase in home care demand. This has a direct correlation with referrals for formal day care or day opportunities support. Current eligibility for attending day care is that customers are in receipt of support of a personal care nature either from home care services or family.

Between 2003 and 2013, East Dunbartonshire experienced the fastest growing increase in people aged 85+ of any local authority in Scotland (from 1,672 to 2,660: an increase of 59%), with steepening future projections

Key Factors to consider regarding the demographics contributing to the increase in the number of older people in East Dunbartonshire:

Longer life expectancy resulting not only in more older people, but an increasing prevalence of people surviving beyond age 85 years, with correspondingly higher prevalence of limiting illnesses;

With increased age comes increased complexity of care needs and associated costs;
The majority of health and social care services are delivered to those aged 75 years +. In 2012-13, 68% of home care customers were aged over 75 years, with most of these aged over 85 years;
Most of these statistics in this section relate to the 85 years + population, due to the intensive nature of the care often provided from this age upwards. However, it is important to note that almost as many service users receive services between the ages of 75 years and 85 years as receive services beyond the age of 85 years;
Community Care policy promotes community-based care, which in the main means care at home, or in a homely place in the community (including care homes). Day Centres or places to provide support in a safe and secure environment are considered an important aspect in supporting individuals to remain in the community.

East Dunbartonshire has felt the impact of these increasing numbers of older people and the associated pressures, perhaps more acutely than other areas in Scotland, and this trend is expected to accelerate.

East Dunbartonshire has witnessed the fastest growing increase in people aged 85 years + (59%) of any local authority area in Scotland over the last ten years.

Future projections demonstrate that this growth in older people in our community will accelerate over the next ten years by a further 74%, compared to a Scottish average of 46%.

Looking even further ahead, the population of people 85 years + in East Dunbartonshire is expected to treble over the next 25 years.

60% of older people currently accessing locally formally funded social support are aged 85 years plus.

Pregnancy and Maternity

While older people are not affected by this protected characteristic, the HSCP recognises that older people may have unpaid carers in this characteristic category. There is no national data was available about unpaid carers under thi]s protected characteristic grouping. It is recognised that the Strategy will have an indirect benefit to supporting unpaid carers to continue in their caring role.

Marriage and Civil Partnership

The Strategy does not make any specific reference to marriage and civil partnerships, the Strategy recognises that unpaid carers will have an indirect benefit to supporting unpaid carers to continue in their caring role. This may include spouses or partners of older people attending social supports. There is no national data available about unpaid carers under this protected characteristic grouping.

59% of older people currently accessing locally formally funded social support are living with a spouse, partner or other family member.

Social and Economic Status
The Scottish Government have developed a Framework that will help them to understand the national issues arising for older people and how policies can work together to the benefit of all older people. It sets a direction of travel in which the Government and partners across sectors can begin to develop action that will make real differences to older people’s lives, now and in the future.

Access to local informal community assets is available to all older people irrespective of their social and economic status. The Council does have a customer contribution policy when the individual accesses formal funded social support. However, income maximisation activities are undertaken to ensure that individuals are in receipt of all relevant benefits. Where customers are financially disadvantaged a financial assessment is undertaken to determine their level, if any, of customer contribution towards social support.

Other marginalised groups (homeless, addictions, asylum seekers/refugees, travellers, ex-offenders)
No data was specifically available about older people under this marginalised group. However, the Scottish Government’s ‘A Connected Scotland’ A Strategy tackling social isolation and loneliness recognises the impact that exclusion and isolation can have on an individual’s physical and mental health.Please see reference to ‘Travellers’ under ‘Race’ characteristics.

Do you expect the policy to have any positive impact on people with protected characteristics?

Highly Likely

General
It is expected that the integration of planning, resource use and service delivery as outlined in the Strategy will have a positive impact on older people to feel socially included with their peer group and an active part of their community.

Sex
It is expected that the integration of planning, resource use and service delivery as outlined in the Strategy will have a positive impact on older people to feel socially included with their peer group and an active part of their community.

Gender Reassignment
It is expected that the integration of planning, resource use and service delivery as outlined in the Strategy will have a positive impact on older people to feel socially included with their peer group and an active part of their community.

Race
The Strategy will apply to all racial groups and where information is required to be translated or provided in alternative formats it will be provided upon request as is the current Council and NHS Policy

Disability
The actions identified in the Strategy are designed to improve access, fairness, consistency and processes associated with supporting older people to feel socially included with their peer group.

Sexual Orientation
It is expected that the integration of planning, resource use and service delivery as outlined in the Strategy will have a positive impact on older people to feel socially included with their peer group and an active part of their community.

Religion and Belief
It is expected that the integration of planning, resource use and service delivery as outlined in the Strategy will have a positive impact on older people to feel socially included with their peer group and an active part of their community.

Age

It is expected that the integration of planning, resource use and service delivery as outlined in the Strategy will have a positive impact on older people to feel socially included with their peer group and an active part of their community.

Marriage and Civil Partnership

Pregnancy and Maternity

None

Social and Economic Status

Other marginalised groups (homeless, addictions, asylum seekers/refugees, travellers, ex-offenders)
The overarching Strategic Plan will take a locality based approach in order to ensure that needs are met, and that inequalities can be reduced.

Do you expect the policy to have any negative impact on people with protected characteristics?

Possible

General
Yes, if the needs of older people are not recognised in all of the Strategy’s consequential improvement actions.

Sex
Yes, if the needs of older people are not recognised in all of the Strategy’s consequential improvement actions.

Gender Reassignment
Yes, if the needs of older people are not recognised in all of the Strategy’s consequential improvement actions.

Race
Yes, if the needs of older people are not recognised in all of the Strategy’s consequential improvement actions.

Disability
Yes, if the needs of older people are not recognised in all of the Strategy’s consequential improvement actions.

Sexual Orientation
Yes, if the needs of older people are not recognised in all of the Strategy’s consequential improvement actions.

Religion and Belief
Yes, if the needs of older people are not recognised in all of the Strategy’s consequential improvement actions.

Other marginalised groups (homeless, addictions, asylum seekers/refugees, travellers, ex-offenders)
Yes, if the needs of older people are not recognised in all of the Strategy’s consequential improvement actions.

Actions to be taken – please list amendments to the policy following assessment.

1 Changes to policy
There are no implications in the Strategy which will impact the human rights of older people, their families, carers, nor those of the wider community to note at this stage, however as the implementation plan progresses further consideration will be given to the impact on equality and human rights.

2 Action to compensate for identified negative impact

As indicated above there are no implications in the Strategy which will impact the human rights of all older people, their families, carers, nor those of the wider community to note at this stage, however as the implementation plan progresses further consideration will be given to the impact on equality and human rights.

3 Further monitoring
potential positive or negative impact
The Integration Joint Board (IJB) as a separate legal entity will operate independently from the Council and the Health Board. An annual performance report is required by statute will be provided by

Lead Reviewer: Name: Kelly Gainty
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Job Title: Adults and Community Care Support Worker
Signature: Kelly Gainty